Pillbox Organizers Can Slow Progression Of HIV To AIDS

HIV-positive people who use pillbox organizers to help adhere totheir antiretroviral drug regimens could reduce the risk of progressingto AIDS, according to a study published in the October issue of thejournal Clinical Infectious Diseases, Reuters Health reports.

For the study, David Bangsberg of San Francisco General Hospitaland colleagues followed 245 HIV-positive people from 1996 to 2000. Theresearchers periodically tracked the participants' adherence to theirantiretroviral regimens by conducting unannounced pill counts everythree to six weeks. All study participants were taking a minimum ofthree different medications.

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The researchers used threestatistical models to compare adherence for individuals who chose touse pillbox organizers and those who did not. Sixty-one percent of thestudy participants used the organizers for at least one month duringthe course of the study. The researchers found that pillbox usersincreased their adherence to prescribed drug regimens by up to 4.5%.They also had substantially lower levels of HIV in their blood and werenearly twice as likely to have a viral load of 400 virus copies permilliliter or less. Pillbox users also were 11% less likely thannonusers to progress to AIDS during the course of the study.

Conclusions

"Pillbox organizers should be a standard intervention to improveadherence to antiretroviral therapy," the researchers wrote, addingthat people living with HIV who do not fully adhere to prescribedregimens increase their risk of developing drug resistance, progressingto AIDS and death. The researchers acknowledged that antiretroviralregimens are simpler now than when the study was conducted, so it isunclear whether pillbox organizers would be as helpful for patientstoday. However, they added that "given the simplicity and low cost ofthe intervention, clinicians should consider including pillboxorganizers in their routine treatment of chronic disease" (Reuters Health, 9/12).

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